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Background <p>Internal hemorrhoids are common, and while endoscopic sclerotherapy is emerging as a treatment, large-scale, multi-center data on its efficacy, safety, and recurrence rates are lacking. We summarized three-center large-sample endoscopic hemorrhoid sclerotherapy data, assess efficacy, complications, recurrence, and analyze recurrence factors (severity, lifestyle).</p> Methods <p>A retrospective analysis of patients with internal hemorrhoids treated with endoscopic sclerotherapy at three centers from December 2018 to December 2022 was conducted. Clinical and follow-up data were collected to assess hemorrhoid grading, treatment efficacy, complications, and recurrence rates. The recurrence rate, recurrence time, and related factors for different hemorrhoid grades were analyzed.</p> Results <p>A total of 1147 patients underwent the procedure: 637 at Shenzhen Hospital of Southern Medical University, 177 at No. 964 Hospital, and 333 at Third Affiliated Hospital, Army Medical University. The overall effective rate was 92.85% (1065/1147). Postoperative safety measures showed the effective group had significantly lower pain (1 (0,1) vs. 2 (2,3)), bleeding (0 (0,1) vs. 2 (1,3)), and urination scores (0 (0,0) vs. 0 (0,1)) compared to the ineffective group. The overall recurrence rate was 12.21% (130/1065), with follow-up periods ranging from 3 to 49&#xa0;months (mean: 25.61 ± 13.23&#xa0;months). Recurrence time was earlier with increasing hemorrhoid grade (<i>p</i> &lt; 0.05). Temporal analysis revealed that for Grades I, II, and III, recurrence rates within one year were 28, 39.78, and 75%, respectively, vs 72, 60.22, and 25% beyond 1 year. Multivariate logistic regression indicated higher BMI and lack of exercise were associated with increased recurrence (<i>p</i> &lt; 0.05), while lower hemorrhoid grade, working position, and dietary habits were protective factors (<i>p</i> &lt; 0.05).</p> Conclusion <p>Endoscopic sclerotherapy is a safe and effective treatment for internal hemorrhoids with a low short-term recurrence rate. Key factors influencing recurrence include BMI, exercise, hemorrhoid grade, working position, and dietary habits, providing insights for optimizing treatment strategies.</p>

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Multicenter analysis of the efficacy and factors related to recurrence of endoscopic sclerotherapy for internal hemorrhoids: a large-sample, retrospective cohort study

  • 期刊论文

  • 发表日期：

    2025年8月26日

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  • Ying Zhu,
  • Yingying Yang,
  • Wen Xu,
  • Xiaohua Bao

摘要

Background

Internal hemorrhoids are common, and while endoscopic sclerotherapy is emerging as a treatment, large-scale, multi-center data on its efficacy, safety, and recurrence rates are lacking. We summarized three-center large-sample endoscopic hemorrhoid sclerotherapy data, assess efficacy, complications, recurrence, and analyze recurrence factors (severity, lifestyle).

Methods

A retrospective analysis of patients with internal hemorrhoids treated with endoscopic sclerotherapy at three centers from December 2018 to December 2022 was conducted. Clinical and follow-up data were collected to assess hemorrhoid grading, treatment efficacy, complications, and recurrence rates. The recurrence rate, recurrence time, and related factors for different hemorrhoid grades were analyzed.

Results

A total of 1147 patients underwent the procedure: 637 at Shenzhen Hospital of Southern Medical University, 177 at No. 964 Hospital, and 333 at Third Affiliated Hospital, Army Medical University. The overall effective rate was 92.85% (1065/1147). Postoperative safety measures showed the effective group had significantly lower pain (1 (0,1) vs. 2 (2,3)), bleeding (0 (0,1) vs. 2 (1,3)), and urination scores (0 (0,0) vs. 0 (0,1)) compared to the ineffective group. The overall recurrence rate was 12.21% (130/1065), with follow-up periods ranging from 3 to 49 months (mean: 25.61 ± 13.23 months). Recurrence time was earlier with increasing hemorrhoid grade (p < 0.05). Temporal analysis revealed that for Grades I, II, and III, recurrence rates within one year were 28, 39.78, and 75%, respectively, vs 72, 60.22, and 25% beyond 1 year. Multivariate logistic regression indicated higher BMI and lack of exercise were associated with increased recurrence (p < 0.05), while lower hemorrhoid grade, working position, and dietary habits were protective factors (p < 0.05).

Conclusion

Endoscopic sclerotherapy is a safe and effective treatment for internal hemorrhoids with a low short-term recurrence rate. Key factors influencing recurrence include BMI, exercise, hemorrhoid grade, working position, and dietary habits, providing insights for optimizing treatment strategies.